| NPI | 1508737511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA66899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03725) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-17 |